Infectious hepatitis

Abstract

Infectious hepatitis describes inflammation of the liver due to transmissible viruses. The five most common viruses recognised are classed alphabetically as A, B, C, D and E. These different viruses cannot be differentiated clinically, but a focused history and examination can provide clues towards aetiology, guide appropriate investigations and allow for identification of complications. Hepatitis A and E are typically enterically transmitted and generally follow a mild and self-limiting course. Hepatitis B, C and D are parenterally transmitted and collectively account for a large burden of chronic liver disease globally. This article will cover clinical assessment and management of patients with viral hepatitis A–E. Although there are numerous other types of infectious hepatitis, labelled ‘non-A–E hepatitis’, they are rare and not routinely tested for in clinical practice so are not covered in this article. We will also not cover viruses with more systemic effects which can cause hepatitis but are not specific to the liver, such as Epstein– Barr virus and cytomegalovirus.